PRS Global is seeking certification from the Alliance for Ethical International Recruitment Practices. To share your experience with PRS Global, please email To find out more about the Alliance, visit

You’ve decided to spread your wings and work as a nurse in a foreign country. With your nursing degree and the global nursing shortage, many prospects exist for working abroad. Maybe you want to travel, have more adventures, earn better, or learn and grow more in your field. 

But moving to a new country and getting used to a new way of life can be tough at first. Understanding these challenges beforehand can help you prepare for them, make your move to the US easier, and set you up for a successful career. 

The Current State of the Healthcare Workforce 

A recent report from the National Council of State Boards of Nursing shows that around 100,000 registered nurses left their jobs in the last two years because of stress, burnout, and retirement during the COVID-19 pandemic. Moreover, an additional 610,388 nurses plan to leave their jobs by 2027 for similar reasons.¹ 

Additionally, the report indicates that 25 percent and 50 percent of nurses said they often experience emotional exhaustion (50.8 percent), several times a week or every day, while others felt: 

  • Used up (56.4 percent) 
  • Tired (49.7 percent) 
  • Burned out (45.1 percent), or 
  • Reaching a point of extreme stress (29.4 percent) 

Considering the facts, we have about feelings of exhaustion and stress, we need to understand the challenges nurses face every day when entering health care in the US. 

Related Reading: World Mental Health Day 2023: 7 Coping Strategies for the Nurse Burnout Syndrome 

By knowing these challenges well, you can actively prepare yourself for the future. Preparing ahead of time will increase your chances of fitting in and provide you with the most fulfilling experience in your nursing career. 

Addressing Common Challenges for Global Nurses 

Even though each global nurse’s experience is unique, there are common challenges that many of them share. 

1. Language Barrier 

Adapting to a country where people speak your language will be easier, though there might still be some words or expressions you won’t understand. But if you move to a country with a totally different language, it can make it hard to communicate well with patients and provide quality patient care. 

If you’re a global nurse planning to work in the United States, you must pass the NCLEX, a national exam for nursing licensure, and an English language test. 

But here’s the thing – the English you learn for tests is not always the same as that used in everyday conversations or medical settings. Additionally, for those who speak English as a second language, patients may sometimes have difficulty understanding t certain accents or non-native speech patterns. 

To improve your language skills, you can enroll in language courses, find a mentor, or practice speaking in English with those around you. You might also consider taking an online course if you want to improve your pronunciation and enunciation of English words to help you better communicate with patients and coworkers. 

Related Reading: Choosing the Right English Language Test: A Comparison Guide for Global Nurses 

2. Cultural Sensitivity 

In your home country, you’re used to how people do things. But in the United States, where patients come from different cultures, things might be unfamiliar. This could sometimes cause misunderstandings. 

We know that moving to a new country might make you feel a bit out of place or experience some kind of “culture shock.” Everything will be different, like how people live and what they expect. Even though it might be challenging at first, it’s important to be open to new ways, step out of your comfort zone, and become a part of the new culture. 

Caring for patients with cultural sensitivity is crucial because it helps them feel respected and understood. Patients who feel valued are more likely to be satisfied and follow care recommendations. 

To handle this, you can actively learn about different cultures. Joining local nursing groups and connecting with experienced professionals can help you understand the cultural expectations in the US healthcare setting. This way, you can provide better care to your patients. 

3. Work Environment 

The practices, policies, and laws can vary significantly between institutions, regions, or countries. You may encounter situations where the established practices conflict with what you learned during your education or in previous work experiences. 

That’s why it’s important to be adaptable and open-minded. Be willing to adjust your approach and learn to align with the specific guidelines and regulations of the US health care environment. 

Additionally, new and improved technologies and ways of doing things are constantly being introduced. You may face challenges in adapting to and mastering these technologies, such as electronic health records (EHRs), advanced medical equipment, or new communication tools. 

Related Reading: The 2023 Guide to Telenursing for Global Nurses 

While it can be a bit challenging to adapt to these changes, it’s an essential aspect of doing your job that makes it way more effective and efficient. Think of it as upgrading your skills to provide even better care for your patients. It’s all about making things smoother and more efficient in the long run. 

4. Understanding the US Healthcare System 

Healthcare in the United States works differently than in your home country, and it might take some time to figure out how things operate. So, it’s really important to familiarize yourself with healthcare policies, insurance procedures, and documentation requirements. 

Try to learn things before you arrive. Make a list of questions to ask during your orientation when you start at your new hospital. 

  • Understanding Policies: Familiarize yourself with healthcare policies. What are the standard practices in the US? How does the healthcare system handle various medical situations? 
  • Insurance Procedures: Learn about insurance procedures. What kind of coverage do patients usually have? How does billing and insurance verification work in US hospitals? 
  • Documentation Requirements: Get to know documentation requirements. What kind of patient records are essential? How does the US maintain and update medical documentation? 

You can use online resources, attend workshops, and ask for guidance from experienced mentors to better understand the US healthcare system. 

5. Homesickness and Emotional Well-Being 

Sure, when you’re in a place far away from where you grew up and work, it’s common to start missing home, your family, or familiar things. It might not happen as soon as you arrive, and you might feel like you’ve adjusted well initially. But after about three months, you might miss home more than before. 

Understanding that this is a normal part of the transition is crucial. Talking to other nurses who are also away from home or joining groups where people share their experiences can make you feel connected. 

Connecting with colleagues, neighbors, and people in your local community can be comforting too. Getting involved in social activities, both at work and outside, makes you feel like you belong. Making friends and getting advice from others who have been homesick can help you not feel so alone. 

You can also do things that make you feel at home, like cooking traditional meals or celebrating your cultural events. Keeping in touch with your family and friends back home, whether through video calls or chats, helps you feel close to them even when you’re far away. It’s like bringing a piece of home with you, making the distance feel a little smaller. 

6. Budgetary Considerations 

Even if the salary seems good compared to what you’re used to, it’s essential to check how much things cost in the new city or town. The cost of living might be higher than you think. 

Living in the United States usually costs between $2,500 and $3,500 each month, varying based on where you live and your lifestyle.² This covers housing, food, transportation, healthcare, taxes, and other additional costs. 

Use online resources to research the cost of living in your new city or town. Look into average prices for housing, transportation, groceries, and other essential expenses. List all potential expenses and any other regular costs and use this to estimate how much you might spend on each expense. 

Compare your estimated budget with the salary offered to you. Ensure that your salary is sufficient to cover your anticipated expenses and leave room for savings. Don’t forget to set aside a portion of your budget for unexpected expenses or emergencies. Consider building an emergency fund to handle unforeseen circumstances. 

Lastly, you can connect with current or former employees who have experience living in the area for firsthand insights. Join online groups or forums where people talk about the cost of living in a new location. 

From Struggle to Success: Rising Above Challenges 

Embracing the challenges of living in the US involves adopting a positive mindset, cultivating patience, and staying open to learning from your new environment. It’s about recognizing that each challenge presents an opportunity for personal growth. Being open-minded allows you to appreciate cultural differences, navigate unfamiliar situations, and build resilience. 

Putting in the effort to face challenges doesn’t just help you survive; it turns your time into an exciting adventure. Overcoming problems helps you grow personally, and the memories you make along the way become the foundation of a rewarding and satisfying life in a new place. 

Related Reading: Top 5 Reasons Why Nurses Pursue a Career in the US 


Here at PRS Global, we’ll partner with you to create the life you want in the US from start to finish. With our direct hiring services, we ensure a seamless transition, personalized support, and the resources you need to thrive in your new journey. Through every challenge, we’re with you every step of the way. Contact us today to get started! 


1 National Council of State Boards of Nursing. “NCSBN Research Projects Significant Nursing Workforce Shortages and Crisis.” NCSBN, 13 Apr. 2023,

2 “Cost of Living in the US for International Students.” Edvoy,